Application For Refund Form- Income Tax Department - City Of Euclid Page 2
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2Refund Application Instructions
Who May Use This From: Persons seeking a refund of municipal tax paid to The City of Euclid.
Note: If the amount of overpayment is less than $1.00, the amount will not be refunded. The IRS must be
notified by the City of Euclid of all refunds in excess of $10.00.
Year of Return: Enter the year for which the claim covers. Located above Status. A separate return is required
for each year filed.
Note: The Statute of Limitations for refunds is three (3) years.
Status & SSN: Please check if this is for an individual or a joint refund and enter the social security numbers
necessary. Please enter the social security numbers clearly.
Name & Address: Please enter the name(s) the refund is requested for and the current address, if you moved in
or out of Euclid during the year.
Type of Claim Filed: Check for type of refund claim you are requesting
A. Under the age limit to pay tax - A readable copy of the birth certificate or driver’s license must accompany the form.
If you reached the minimum age to pay tax during the year, your employer must complete the employer’s certification and provide
a breakdown of how much was earned before your birth date and how much was earned after your birth date.
B. Time out of the employment city – Must be documented with a travel log showing the date, place and
business purpose of travel. The employer’s certification must be signed. The following formula is used to arrive at the percentage
of income to be excluded from tax:
Days Worked Out of the City X Local Wages= Amount Excluded
Total Working Days (260)
Saturdays, Sundays, sick days, vacation days, and holidays are not to be counted as days worked out of the city. Total working
days should be 260, unless you worked a partial year. On the income earned while traveling, you will owe residence tax to your
home city at the full percentage rate.
C. Unreimbursed Business Expenses - You must explain in detail and document claim. Federal form
2106 and Federal Schedule A, must be submitted for business expenses. For municipal tax purposes, the
deduction is limited to unreimbursed employee expenses less 2% of Federal Adjusted Gross Income (AGI).
D. Other – You must explain in detail and document the claim. Federal form 3903 must be submitted for moving expenses.
Computation of over payment:
Line 1. Enter the amount of local wages that your employer showed on your W-2 Form. Wages that are deferred for Federal
and state purposes except 125 plans must be included in Local Wages. All W-2 forms, 1099’s, and statements showing
reimbursements must be attached.
Line 2. Enter the amount of wages that are to be excluded from tax.
Line 3. Subtract the amount on line 2 from the amount shown on line 1.
Line 4. The corrected tax is found by multiplying the net taxable taxable wages times 2.85%.
Line 5. The amount of tax withheld by your employer.
Line 6. A prior year amount taken as a credit.
Line 7. Estimated payments made to Euclid.
Line 8. Total amount of credits.
Line 9. The amount of your refund request is found by subtracting the amount line 8 from the line 4 amount.
Sign Your Return: Your return is not compete if it is not signed. On a joint return, both husband and wife must sign. If you
are filing this form on behalf of another person, a Power of Attorney form must accompany this form.
Employer Certification: The Employer’s Certification must be signed by the employee’s supervisor or other responsible
representative of the employer who has knowledge that the information given is true and correct. If more than one employer,
each employer must sign a separate certification.
Penalties for filing a Fraudulent Return: Persons filing a fraudulent return shall be guilty of a misdemeanor and shall be
fined not more than One Thousand Dollars ($1000.00) and or imprisoned for not more than six (6) months or both, for each
offense.
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